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There is a trend toward increased surgical treatment of displaced clavicle fractures in the adolescent population presumably because of extrapolation of adult-derived best practice guidelines. The purpose of this study was to compare return to sport between nonoperative and operative treatment of clavicle fractures in high school athletes.

A retrospective review of clavicle fractures sustained in scholastic athletes participating in school-sponsored athletics in the upstate South Carolina was performed from 2015 to 2019. Injury circumstances, demographics, radiographs, treatment, and return to sport data were documented for all patients. Radiographs were evaluated for fracture location, comminution, displacement, shortening, and angulation. Patients were followed until complete return to sport, and results were compared based on sport participation, injury mechanism, fracture morphology, treatment type, and time to return to sport.

Forty-seven patients (44 were male; average age 15.6 years) were includet athletes with clavicular fractures predictably return to athletics, including collision sports. Athletes conservatively managed returned 40% faster than those with surgery. However, this appears to be associated with the severity and complexity of fractures treated surgically. This study provides evidence to counsel adolescent athletes following clavicular fractures on return to sport expectations.

Our results show that adolescent athletes with clavicular fractures predictably return to athletics, including collision sports. Athletes conservatively managed returned 40% faster than those with surgery. However, this appears to be associated with the severity and complexity of fractures treated surgically. This study provides evidence to counsel adolescent athletes following clavicular fractures on return to sport expectations.

A periprosthetic joint infection (PJI) in the shoulder can be difficult to diagnose. Sovilnesib ic50 Many variables have been used to determine a PJI. Recently, the 2018 International Consensus Meeting (ICM) on orthopedic infections gave new criteria to help identify PJI in the shoulder. With the new criteria (major and minor), the PJI definition can be categorized into definite, probable, possible, and unlikely. This study was conducted to assess the new criteria for a series of consecutive first stage revision shoulder arthroplasty cases.

All patients undergoing a first stage revision shoulder arthroplasty using a prosthesis made of antibiotic-loaded acrylic cement (PROSTALAC) spacer from 2016 through 2019 were evaluated retrospectively. All cases were performed by a single surgeon. Each case was reviewed using the 2018 shoulder ICM diagnostic criteria. Secondary factors evaluated were type of organism identified, accuracy of minor criteria, and frozen vs. permanent section accuracy.

A total of 87 first-stage revisioe research into determining periprosthetic shoulder infection is needed to help identify which patients are more likely to have an infection.

The biomechanical relationship between irreparable rotator cuff tear size and glenohumeral joint stability in the setting of superiorly directed forces has not been characterized. The purpose of this study was to quantify kinematic alterations of the glenohumeral joint in response to superiorly directed forces in a progressive posterosuperior rotator cuff tear model.

Nine fresh-frozen cadaveric shoulders (mean age; 58 years) were tested with a custom shoulder testing system. Three conditions were tested intact, stage II (supraspinatus) tear, stage III (supraspinatus + anterior half of infraspinatus) tear. At each condition, range of motion and humeral head positions were measured with a "balanced" loading condition, and with a superiorly directed force ("unbalanced loading condition"). At each of the 0°, 20°, and 40° of glenohumeral abduction positions, all measurements were made at 0°, 30°, 60°, and 90° of external rotation (ER). Two-way repeated measures analysis of variance with Tukey post hoc tests weger tears involving the anterior half of the infraspinatus tendon caused significant superior and posterior translations within the middle ranges of ER for all abduction angles. In addition to superior instability, posterior translation should be considered when selecting or developing surgical techniques for large posterosuperior rotator cuff tears.

With superiorly directed loads, complete supraspinatus tendon tears created superior translations at all abduction angles, and posterior instability in the middle ranges of rotation for 20° and 40° of abduction. Larger tears involving the anterior half of the infraspinatus tendon caused significant superior and posterior translations within the middle ranges of ER for all abduction angles. In addition to superior instability, posterior translation should be considered when selecting or developing surgical techniques for large posterosuperior rotator cuff tears.Orodispersible mini-tablets (ODMTs) are a promising dosage form for the pediatric use showing increasing interest from pharmaceutical industry. However, a scale-up process for ODMTs from a compaction simulator to a rotary tablet press following FDA and EMA guidelines has not been performed and investigated yet. Isomalt (galenIQ™721) and Ludiflash® both excipients with proven suitability for the development of ODMTs have been investigated in transfer and scale-up from a compaction simulator to a rotary tablet press. ODMTs with isomalt and Ludiflash® were produced on the rotary tablet press monitoring the product temperature over time and assessing the properties of the residual powder in the feed shoe. Critical quality attributes like tensile strength, mass and disintegration time were evaluated. The transfer from compaction simulator to rotary tablet press succeeded as for both excipients similar disintegration times, tabletability and compactibility profiles were obtained. However, during scale-up, disintegration time significantly increases over time for both excipients. Monitoring of the product temperature revealed that with increasing batch size the product temperature increases as well having a significant impact on disintegration time. The properties of ODMTs produced with the residual powder are comparable in tabletability and disintegration time compared with ODMTs produced from fresh powder.